The Basics

When you work, some of the money you earn automatically comes out of your paycheck and helps fund Medicare, a national public health insurance program which helps pay for the medical costs of people who qualify.

If you or your spouse works enough time while paying Medicare taxes, you qualify for Medicare:

  • When you turn 65
  • After you get Social Security Disability Insurance (SSDI) benefits for two years, or
  • If you have end-stage kidney disease (ESRD) or Lou Gehrig’s disease (ALS).

If you get Childhood Disability Benefits (CDB) benefits for two years based on a parent’s work record, you also qualify for Medicare.

If you have Medicare coverage, it’s important for you to understand:

  • Which parts of Medicare might help you
  • The differences between Original Medicare and Medicare Advantage
  • What you have to pay for Medicare
  • How you can get help paying for Medicare, and
  • How to sign up for different Medicare benefits.

If you have questions about Medicare and need to talk with somebody:

  • After you get SSDI for two years, Part A and Part B of Original Medicare coverage start automatically.
  • Each year, Medicare has open enrollment between October 15 - December 7. During this time, you can switch between Original Medicare and Medicare Advantage or change which Part D or Medicare Advantage plan you have. If you also get Medi-Cal benefits, you can change plans at any time.
  • You can have Medicare and other health coverage at the same time and they may work together to pay for your medical expenses.
  • If you have low income, Medi-Cal, Medi-Cal's Working Disabled Program, Medicare Savings Programs, and the Low Income Subsidy (LIS) may help you pay for Medicare.
  • If you get SSDI benefits, but they stop because you make too much money at work, Medicare coverage may continue for 93 more months (seven years and nine months) or more.

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